Oxford University Hospitals
NHS Trust
Ankle sprain
advice
Instructions for patients
What is an ankle sprain?
An ankle sprain is a common injury, often caused when the ankle
is forced to bend more than normal. This stretches and weakens
the ligaments and soft tissues that hold the ankle and foot bones
in place.
What are the symptoms?
• mild ache to sudden pain
•swelling
•bruising
• inability to move the ankle normally.
How is it treated?
The first treatment is to calm the inflammation and control
the swelling and pain. This can be managed with the ‘RIPE’
treatment (Rest, Ice, Painkillers, Elevation).
Early weight bearing (putting weight on your injured foot) has
been shown to help sprained ankles to heal more quickly. This
is why most people with an acute ankle sprain will not be given
crutches. Always try to walk normally, with your heel striking the
floor first, then rocking forward on your foot and pushing off
with your toes.
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R Rest: Rest will help prevent further injury and allow the
healing process to begin. For the first few days, reduce the
amount of walking you do and gently exercise your ankle
regularly to avoid stiffness. Avoid forceful and strenuous
activity, such as running and jumping, until you can walk
without it causing any pain.
I
Ice: Ice can help reduce swelling and reduce pain. Make
an ice pack by wrapping a small bag of frozen peas (which
you can re-use several times by re-freezing, but please do
not eat them after doing this) or some crushed ice cubes
in a damp towel. Put the ice pack on your injured ankle
for 10 minutes every 2 hours, for the first couple of days
after the injury. Then use the ice pack 3 times a day until
the swelling goes down.
P Painkillers: It is important that you take regular
painkillers, to reduce the pain and help you keep
moving around. Paracetamol and ibuprofen are effective
painkillers if they are taken regularly. They can be taken at
the same time. We do not routinely prescribe or dispense
these painkillers, as they can be cheaply purchased over
the counter at chemists and most supermarkets. Please
read the instructions on the packets carefully for the
correct dose to take and reasons why you might not be
able to take these medications.
E Elevation: Keeping your injured ankle raised above the
level of your hips for the first few days after injury. This
helps to decrease the swelling and pain. We no longer
offer compression bandages for sprains, because they
appear to have no beneficial effect on how quickly or fully
you recover. Some people do find them comforting to use
on sprained limbs and they can be purchased from most
pharmacies if you wish to try them.
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Rehabilitation and recovery
Healing of the ligaments normally takes about six weeks,
although everyone recovers from injuries at different rates.
Healing time is related how severe your injury is and any other
medical problems that you might have.
As healing gets underway, it is important that you begin a series
of exercises, to help you get back the full use of your ankle by
improving its flexibility and strength. This will help to reduce the
risk of further sprains.
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Exercises
At first your ankle will feel stiff and possibly painful. This is
because it has been held in one position. By exercising regularly
the feeling of stiffness and pain will gradually ease. The following
exercises need to be done regularly; 3-4 times per day.
Dorsiflexion and plantarflexion
Pull your foot upwards as far as you
are able, hold for 5 seconds, and then
point your foot away from you as far
as you are able, hold for 5 seconds.
Repeat ___times.
Inversion and eversion
Turn the sole of your
foot inwards and then
outwards (keeping your
knee still).
Repeat___times.
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Assisted exercises
Use a towel or something
which does not stretch to
assist with dorsiflexion,
inversion and eversion
exercises.
Ankle slides
Sit on a chair with your feet
flat on the floor. Slide your
injured foot backwards along
the floor, keeping your foot
flat on the floor throughout.
Repeat___times.
Toe crunching
Sit on a chair and place a
towel on the floor. Put your
injured foot on the towel
and, using your toes, ‘bunch’
the towel up and pull it
towards you.
Repeat___times.
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Seated heel raises
Sit in a chair with both feet flat on
the floor. Raise your heels up off
the floor then lower them back
down slowly
Repeat___times.
It will be safe for you to return to your normal activities when
you have:
• full strength
• full range of movement
• can use your ankle without pain or causing any swelling.
If you have persistent problems with pain, swelling, you are not
able to use your ankle properly, or your ankle is not recovering at
the rate you expect, please see your GP.
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How to contact us
If you have any questions or concerns, please contact:
Minor side
Emergency Department
John Radcliffe Hospital, Oxford
Tel: (01865) 220 224
Emergency Department
Horton General Hospital
Tel: 01295 229 415
Alternatively, you can contact your GP or NHS 111 (dial 111
(freephone) from any landline or mobile).
If you have a specific requirement, need an interpreter,
a document in Easy Read, another language, large print,
Braille or audio version, please call 01865 221 473
or email PALSJR@ouh.nhs.uk
Author: Emergency Nurse Practitioner Team, Physiotherapy Team
August 2015
Review: August 2018
Oxford University Hospitals NHS Trust
Oxford OX3 9DU
www.ouh.nhs.uk/information
OMI 12384P